Name of the Patient : Abc Xyznt lmn / M / 58 yrs.
Referred by : Dr. Abc Xyzkhi.
Examination : M.R.I. of the Lumbo-sacral Spine.
CLINICAL PROFILE :
C/O backache with pain radiating to the RLE since 4-5 months.
M.R.I of the lumbo-sacral spine was performed using the following parameters :
5 mm thick T1 Weighted and T2 Weighted sagittal images.
5 mm thick T1 Weighted and T2 Weighted axial images.
There is loss of normal lumbar lordosis and loss of water content of all the lumbar intervertebral discs except the L1-L2 disc.
There is mild retroplacement of the L5 vertebra over the S1 vertebra.
There is a large right postero-lateral disc extrusion narrowing the right neural foramen and impinging the exiting right L5 nerve root at the L5-S1 level within the neural foramen. Postero-central and left postero-lateral disc herniations with left neural foraminal narrowing are noted at this level.
A posterior disc herniation is seen to indent the thecal sac and narrow both neural foramina at the L4-L5 level.
Right postero-lateral and right far lateral disc herniations are seen to indent the exiting right L3 nerve root and narrow the right neural foramen at the L3-L4 level.
Bilateral far lateral disc herniations are noted at the L4-L5 and L5-S1 levels. Small posterior peridiscal osteophytes are noted at these levels.
A right far lateral disc bulge is noted at the L2-L3 level.
The lumbar facet joints show mild degenerative changes. Effusion is seen within the L5-S1 facet joints bilaterally.
The lumbar intervertebral discs show loss of water content.
Type II degenerative changes are seen in the L4, L5 and S1 vertebral bodies.
The rest of the lumbar vertebral bodies reveal normal signal intensity. The visualized pre and paravertebral soft tissues are unremarkable.
The conus medullaris terminates at the L1-L2 level and the thecal sac terminates at the S1-S2 level.
The antero-posterior dimensions of the lumbar canal at the level of the intervertebral discs are as follows :
17.0 mm at L1-L2
15.0 mm at L2-L3
16.0 mm at L3-L4
11.0 mm at L4-L5
11.0 mm at L5-S1.
The MRI features are suggestive of :
1. A large right postero-lateral disc extrusion impinging the exiting right L5 nerve root at the L5-S1 level and also a postero-central and left postero-lateral disc herniation at the L5-S1 level.
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2. A posterior disc herniation at the L4-L5 level.
3. Right postero-lateral and right far lateral disc herniations indenting the exiting right L3 nerve root at the L3-L4 level.
4. Mild facetal arthropathy in the lumbar region.